The future of hospital food

Janet Howard is the director of the Healthier Hospitals Initiative at Practice Greenhealth, a non-profit with the mission to improve the health of health care, both by creating a healthier environment for patients and professionals and by creating an overall healthier planet through educational efforts and best practices. HCBN spoke with Howard to get some more information on what the organization’s educating hospitals about in regard to food.

HCBN: How much of a shift has there been with hospitals looking to serve healthier food?

JH: The prerequisite to the Healthier Hospitals Initiatives’ Healthier Food Challenge is signing the Health Care Without Harm Healthy Food Pledge. Through the pledge, hospitals commit to taking steps to green food service operations while providing opportunities to educate patients, staff and visitors about the way food is grown/produced, processed and distributed thereby impacting the health of individuals and communities. Among Practice Greenhealth members — in 2010, 47 percent signed the pledge and by 2013, 69 percent had signed the pledge. While many hospitals we work with are undertaking sustainability initiatives, it’s only more recently that healthy food initiatives are part of an overall sustainability strategy, where hospitals recognize the link between sustainable food and health.

In regard to the food impact for the Healthier Hospitals Initiative, there are three points:

1. Balanced menus – the goal is to reduce meat procurement by 20 percent and increasing the quality of the meat procured.

2. Local, sustainable and/or organic purchasing – the goal is to increase local and/or sustainable food procurement by 20 percent from baseline. There has been an exciting shift in helping hospitals in these complex procurement contracts as a way to not only reduce food miles, but also support their local communities, putting those dollars right back into the communities they serve.

3. Healthier beverages for people and the planet – the goal is to increase the purchase of healthy beverages by 20 percent from baseline. Most hospitals taking this challenge are far surpassing this goal.

Some hospitals we work with are challenged in their efforts to reduce meat because they say their sales aren’t as strong as those for less healthy options. Hospitals with the greatest success have a chef that creates interesting and delicious meals and over time, sales for vegetarian options or healthier choices increase. If you’re reducing meat procurement, it really must be balanced with interesting and delicious options. Health Care Without Harm has compiled menu options in their Balanced Menus Recipe Toolkit.

HCBN: In what ways are those chefs helping to improve offerings?
JH: Some are doing scratch cooking — working with fresh ingredients and preparing the food onsite to order. They’re offering smaller serving sizes for meat, more vegetarian options, and greater variety of seasonal fruits and vegetables. They’re also educating staff and patients about the health benefits of healthier eating and how their food choices support the local community.

This year, we partnered with Food Day on October 24 and had more than 230 hospitals committed to participating by agreeing to serve at least one meat item raised without the routine use of sub-therapeutic antibiotics. For example, University of California in San Francisco has announced that they will only serve antibiotic-free chicken to patients and visitors.

HCBN: What kind of changes does this make to their budgets?
JH: The healthier meat costs more, but that’s also why meat reduction is a core component to balance the budget. That’s also why it’s so important to make the connection between antibiotic resistance and costs. We also need to look at the health care costs of treating obesity and diabetes — medical costs of those problems run into the hundreds of billions.

HCBN: What types of challenges do hospitals face with offering healthier options? Are there substantial challenges to sourcing, to food prep, storage, etc.?
JH: I would say, as with any sustainability initiative, it definitely can change the way you do things. Chopping vegetables, even, could require a little extra time, maybe some training. Composting is another thing.

These can be real barriers because many people get nervous with change — they’ve done the same things for a long time. It requires teamwork. One of the key ways to make the change is to take baby steps and provide data. Hospitals are looking for information to track and report on what they’re doing. This requires participation from their food vendors including distributors and food service management companies; group purchasing organizations play a role as well. If you’re a larger facility, you’re more likely to get that information you seek, whereas the smaller organizations have to do a lot of work to get the information they need.

Still, the power of this transformation at its core is taking place with individuals — many passionate champions are out there working to create healthier environments and are part of something much larger than just their own efforts. And that aggregate information is a strong message to the businesses providing foods and services to the health care sector.